1. Field of the Invention
The invention relates methods and systems for managing healthcare information of medical patients using a central computer database which is accessible to remote clients, portable access devices such as smart cards, and distributed computer systems at medical practitioners, pharmacies, insurers, and other medical providers.
2. Description of the Prior Art
In a large multi-discipline medical clinic setting it is customary to maintain a common database of the patient's medical data which can be accessed by different practitioners who may treat the patient from time to time. The same database may also be used for billing and coordination of insurance benefits. The practice of maintaining a common database has obvious benefits and efficiencies compared to the option of each healthcare provider keeping separate records. One major benefit is that a practitioner providing treatment to a patient can access the patient's entire health record, which may be relevant to the current treatment. A central database is a much more efficient way to provide data than relying on the patient to relate the important information to each practitioner or having all of the practitioners confer with each other. However, few patients are able to rely on a single clinic for all of their healthcare needs, and many patients rely on an assembly of unrelated practitioners for primary medical care, medical specialties, dentistry, eye care, unconventional treatments, pharmaceuticals, and the like.
Most patients must rely on a system where their records are distributed among a number of healthcare providers, physicians, dentists, nurse practitioners, unconventional practitioners, pharmacies, opticians, laboratories, and etc. This creates many opportunities for error. A physician may prescribe drugs which interact adversely with other drugs the patient is being given by another physician, or which are contraindicated for a condition which is being treated by another physician. In an environment where patients are treated by unrelated practitioners, as is often the case, it is likely that errors in prescribing will take place. Even when a single physician is treating a patient, there is room for error in computing the dosage and selecting the proper drug name, for instance among several related drugs with similar names.
Pharmacies can improperly fill a written prescription due to misreading of a handwritten prescription. Due to similarities in the trade names of drugs, even electronic prescriptions are subject to errors.
Another problem is lack of feed back that a prescription has actually been fulfilled by a patient. A doctor who prescribes a medication can only assume that the patient actually secures the prescription, and continues to refill the prescription as required from time to time. In the case of elderly patients, impoverished patients, or the mentally infirm this is not necessarily a good assumption. In the current environment, there is no feed back that a patient ever fills a prescription or continues to refill the prescription for physicians and patients outside of a large integrated clinic setting. Errors due to mismanagement of prescriptions and medications have led to several thousands of lost lives in the United States alone.
Smart cards have been proposed for containing general patient information, emergency contacts, allergies, conditions and the like.
U.S. Pat. No. 5,943,423 teaches use of a smart token system (smart cards) to facilitate secure transactions, including storage and transmittal of patient medical information. U.S. Pat. No. 5,995,965 teaches use of a smart card to access data, such as health data, in remote databases. U.S. Pat. No. 5,899,998 teaches a method and system for maintaining computerized medical records in a distributed system without a central database. U.S. Pat. No. 5,974,124 teaches a method and system for taking patient medical readings, storing them on a smart card, and uploading the data to a primary computer. U.S. Pat. No. 5,628,530 teaches a method and system for tracking the demographics of starter drug samples using smart cards to track the prescriptions. U.S. Pat. No. 6,011,858 teaches a memory card containing a biometric template of a user for security and verification purposes.
There is a need for a healthcare information management system which gives a patient using the services of a variety of generally unrelated healthcare practitioners and providers with control over their health records and the ability to provide comprehensive access to the patient's health records as would occur in a centralized clinic setting to in effect create a virtual medical clinic.
There is a need for methods and systems for improved prescription preparation and fulfillment based on use of a patients comprehensive digital health history which provides verification of proper choice of medication and proper fulfillment of the prescription by a pharmacy.
There is a need for an improved method and system for prescription preparation and fulfillment which provides automatic feedback when a prescription is fulfilled, in order to reduce errors relating to medications.